ArticleRadiation oncology (London, England)2015
Positioning accuracy during VMAT of gynecologic malignancies and the resulting dosimetric impact by a 6-degree-of-freedom couch in combination with daily kilovoltage cone beam computed tomography.
Article in Radiation oncology (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Prevention and management of radiotherapy-related toxicities in gynecological malignancies. Position paper on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology).La Radiologia medica · 2024Guideline
- VMAT-based total body irradiation on a conventional LINAC: workflow, procedure and preliminary results.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Impact evaluation of intra-fractional variation on online adaptive radiotherapy for postoperative cervical and endometrial cancer.World journal of clinical oncology · 2025Article
- Continuing Professional Development - Radiation Therapy.Journal of medical radiation sciences · 2024Article
- Comparing immobilisation devices in gynaecological external beam radiotherapy: improving inter-fraction reproducibility of pelvic tilt.Journal of medical radiation sciences · 2024Article
- Weekly Image Guidance in Patients With Cervical Cancer Treated With Intensity-Modulated Radiation Therapy: Results of a Large Cohort Study.Cancer medicine · 2024Article
- Effect of body contour changes on the setup and dosimetric accuracy of radiotherapy after cervical cancer surgery.Frontiers in oncology · 2024Article
- Correcting rotational error in rectal cancer radiation therapy: Can planning target volume margins be safely reduced?Journal of medical radiation sciences · 2022Article
- Dosimetric impact of rotational setup errors in volumetric modulated arc therapy for postoperative cervical cancer.Journal of radiation research · 2021Article
- Geometric accuracy evaluation of a six-degree-of-freedom (6-DoF) couch with cone beam computed tomography (CBCT) using a phantom and correlation study of the position errors in pelvic tumor radiotherapy.Translational cancer research · 2020Article
- Pelvic multi-organ segmentation on cone-beam CT for prostate adaptive radiotherapy.Medical physics · 2020Article
- The impact of the three degrees-of-freedom fiducial marker-based setup compared to soft tissue-based setup in hypofractionated intensity-modulated radiotherapy for prostate cancer.Journal of applied clinical medical physics · 2019Article
- Cone-beam CT reconstruction for non-periodic organ motion using time-ordered chain graph model.Radiation oncology (London, England) · 2017Article
- Initial Clinical Experience Treating Patients With Gynecologic Cancers on a 6MV Flattening Filter Free O-Ring Linear Accelerator.Advances in radiation oncologyArticle
- Immobilization versus no immobilization for pelvic external beam radiotherapy.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation OncologyArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo improve the delivery of radiotherapy in gynecologic malignancies and to minimize the irradiation of unaffected tissues by using daily kilovoltage cone beam computed tomography (kV-CBCT) to reduce setup errors.
methodsThirteen patients with gynecologic cancers were treated with postoperative volumetric-modulated arc therapy (VMAT). All patients had a planning CT scan and daily CBCT during treatment. Automatic bone anatomy matching was used to determine initial inter-fraction positioning error. Positional correction on a six-degrees-of-freedom (6DoF) couch was followed by a second scan to calculate the residual inter-fraction error, and a post-treatment scan assessed intra-fraction motion. The margins of the planning target volume (MPTV) were calculated from these setup variations and the effect of margin size on normal tissue sparing was evaluated.
resultsIn total, 573 CBCT scans were acquired. Mean absolute pre-/post-correction errors were obtained in all six planes. With 6DoF couch correction, the MPTV accounting for intra-fraction errors was reduced by 3.8-5.6 mm. This permitted a reduction in the maximum dose to the small intestine, bladder and femoral head (P=0.001, 0.035 and 0.032, respectively), the average dose to the rectum, small intestine, bladder and pelvic marrow (P=0.003, 0.000, 0.001 and 0.000, respectively) and markedly reduced irradiated normal tissue volumes.
conclusionsA 6DoF couch in combination with daily kV-CBCT can considerably improve positioning accuracy during VMAT treatment in gynecologic malignancies, reducing the MPTV. The reduced margin size permits improved normal tissue sparing and a smaller total irradiated volume.
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